From the mag: Technology gets amputees riding

Editor's note: The following article appeared in the June 1 issue of Bicycle Retailer & Industry News.

BETHESDA, MD—It takes a lot for a double, triple or quad amputee to enter public space, much more to walk or roll into a bike shop.

Yet thanks to programs like Ride 2 Recovery, for many injured military veterans cycling is a lifeline, and they are as passionate as any cyclist about getting their miles in.

“Not a lot of people are comfortable with these guys, yet any shop mechanic can service a hand cycle, and any fitter can help an amputee get more comfortable on their bikes,” said Ray Clark, program manager of Project Hero at Ride 2 Recovery.

The Hero program keeps a fleet of 50 bikes and hand cycles at Walter Reed National Military Medical Center, where Clark instructs vets in how to ride a bike and how the brakes and the gears work. He also leads group rides.

“In the beginning there was a little resistance from the doctors who thought getting some of these guys on two wheels was not such a good idea. But now the cycling program is seen as a very important part of the rehabilitation plan,” Clark added.

Clark spent 15 years in Maryland managing a bike shop but found he enjoyed event support more than working inside.

As far as adaptive components Clark uses to help injured soldiers ride, he has had good luck with Shimano Dual-Control levers because they are easy to manipulate by injured hands or stumps. And brake levers that pull two cables at once allow a single good hand to modulate braking.

Certified to Trek’s level one and two fitting programs and Slow Twitch’s FIST, none of Clark’s training was specific to the physical and mental injuries he works with day to day. But his bicycle fit training provides about 90 percent of what he needs.

“There is no difference fitting a person with one of my knees. The issues are still the same. Some double amputees may need a little different fit, but any shop that fits bikes can fit a bike to an amputee,” said Brian Bartlett, whose artificial knee, Bartlett Knee, is used by above-knee amputees and sold by Fabtech Systems.

Bartlett lost his leg in a car accident. An extreme skier at the time, all he wanted to do was get back to making 100-foot drops skiing the remote backcountry.

“I realized if I could get the knee I was developing to pedal smoothly it would do everything else I wanted. So I started to develop the knee on a bike. I wasn’t a cyclist, but somewhere doing the development work I fell in love with cycling,” he said.

Given his extreme skiing background, Bartlett gravitated to freeriding and downhill racing, and before he knew it he was signed to Iron Horse’s downhill team and competing in Red Bull events around the
world.

“It didn’t bother Iron Horse I was riding with a prosthetic leg, and it didn’t keep me from competing against able-body racers. It may have started out as development work, but I love riding,” he said.

Military personnel familiar with Bartlett’s success on the bike saw the potential in his knee to help wounded soldiers regain impressive mobility. Invited to Washington, Bartlett ended up with a contract to build his knees for the military.

Bartlett’s current knee sports a patented multi-durometer elastic tendon configuration and a stock RockShox Monarch 4.2 air/oil shock. Bartlett says any bike shop can service the shock in his knee since it is a stock bike part.

Adaptive hand cycles are an entirely different market

Riders who have lost too much of their legs to be fitted with prosthetics can be fitted to hand cycles. Fitting and adjusting a hand cycle gets down to comfort and power transfer, much like fitting a bike.

“Given the high cost of hand cycles, they are mostly insurance purchases. But there is plenty we do to fit the rider to the cycle and equipment suggestions,” said Hal Honeyman, owner of The Bike Rack in St. Charles, Illinois. Honeyman also runs Creative Mobility, which specializes in adaptive cycling.

Honeyman travels around the country with a demo fleet of 50 adaptive bikes, mostly to support Wounded Warrior Soldier Rides.

“Like anything else, to get better at fitting a rider to a hand cycle or a recumbent you have to have hands-on experience doing it. But there is nothing new about the process to any bike shop,” Honeyman added.

Some of the adaptive pedals used in recumbent fitting may be new to shops, but many of them can be ordered from Quality Bicycle Products or Freedom Concepts. Other equipment, like Schlumpf cranks, are just utilized in a different way on hand cycles.

“On a hand cycle, Schlumpf cranks are shifted by tapping a shifter button with your elbow, not your heel. Believe me, being able to do that front shift without having to route a cable is a big thing,” said Larry Black at Mt. Airy Bicycles in College Park, Maryland.

Running shifters on hand cycle pedals requires long cable runs, so the cable can follow the pedal and shifter around. But the constant flexing of the housing means cable and housing life is short.

Shimano’s Di2 system is getting some spec on these bikes because of its ease of use and the control wire is lighter and more flexible than cable housing. But Black and others are waiting for wireless activation of a Di2 or other electric drivetrain, which apart from price will solve many setup issues.

“Hand cycles come in with crooked cranks that may be set too high or too low for the rider. Wheels could be out of alignment and tires underinflated, but this is standard shop service and correcting it can bring the joy of cycling back,” Black said.

Adaptive cycling coming to you

The Project Hero program at Walter Reed has been so successful that the Department of Veterans Affairs will be starting cycling programs at VA hospitals and Warrior Transition Units around the country.

Transition Bike Co., Bartlett’s current bike sponsor, is developing gravity skills clinics for Bartlett to lead. “They are open to able-body riders, but given my situation I want to attract amputees to give the sport a try,” Bartlett said.

And Hal Honeyman is growing his Creative Mobility demo tours, continuing to support Wounded Warrior Soldier Rides but also showing up at able-body events to get the general cycling public more familiar with the wide range of adaptive cycles.